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When our old friends see Frederik, even the best of them might say, “If I ever get a brain injury, I’m going to exercise like mad every day to get better.” I get so irritated when they say things like that, for it shows they’re only pretending that they think Frederik’s innocent. They haven’t understood anything.
If man had a self located outside the brain, and that self could stick to a decision to rehabilitate intensively, even after the brain was damaged, it could also stick to a decision to not commit crimes. Then Frederik would deserve to rot away in some jail. And then if he ever came out, we wouldn’t be able to look ourselves or our friends in the eye; we’d have to take new names and move far away. But we have no such self. Outside the brain, there’s nothing.
That’s also why it’s such a relief to go to support group. Everyone there knows the score. They’re not just pretending to.
After I’ve shuffled around the same area for more than half an hour, I venture farther down the hospital’s deserted corridors. There I meet a petite dark-haired woman with a pageboy. I say, “They’ll come out and call us in, won’t they?”
“Come out and call us in.”
“Yes. It’s just taken so long that I’ve started to have doubts.”
“Doubts.”
“Yes, we got a letter saying we were going to have an examination with Dr. Lebech.”
“Lebech.”
“Right. She’s a neuropsychologist here.”
“She is, right. She’s a neuropsychologist here.”
I feel like an idiot, looking at the small woman sweetly smiling up at me. How do I extricate myself?
I say, “Thank you for your help.”
“But thank you for your help.”
I’ve read about echolalia—when someone with brain damage can’t help but repeat what another person says. Perhaps she suffers from echopraxia too? A cold impulse makes me raise my right hand and wait. But she doesn’t raise hers; it’s only words that she mimics.
Behind one of the doors a toilet flushes, and a grey-haired, even more diminutive woman emerges.
“I was just standing here talking to your daughter,” I say.
Behind me I hear a voice. “Talking to your daughter.”
“Do you know whether they’ll call us, or do we go someplace first and let them know we’re here?”
I try not to listen to the daughter while the mother tells me we’ve done exactly what we should have. We just have to keep waiting. “Then a secretary will come and call you.”
“A secretary will call you.”
A few months ago, I never imagined that this secret world existed, tens of thousands of homes where there was brain damage in the family. Pigheaded people I’ve argued with in the supermarket, irrationally angry folks on the sidewalk, blockheads at public meetings—now I realize that many of them are literally sick in the head. And lots of them have friends and families who love them, and who meet up like we do in my new group.
It’s as if I’m in some film, where suddenly I can see and hear all the ghosts who walk among us. People with brain injuries have been here the whole time. I’ve met them, spoken with them, argued with them—and suspected not a thing.
• • •
By now, I’ve read lots of stories about people who have undergone neurological changes without anyone noticing. It could be due to a fall from a ladder or a bike, or to a slowly growing tumor.
We don’t normally go around diagnosing each other. Even after a thousand arguments and a divorce, it rarely occurs to a person that it might be brain damage that transformed their engaged and socially adept spouse into someone cold and stubborn. It’s only when you look back that all the pieces fall into place.
So when did what the doctors call insidious personality changes begin with Frederik?
In the case of an orbitofrontal tumor, the first signs typically appear when your partner begins to make choices that you don’t understand, and he becomes more adamant about these choices than usual. The neurologists use the word rigid for this lack of flexibility. They say that word a lot.
In addition, you should keep your eye on whether he becomes more easily distracted by immediate pleasures and impulses. For example, he might be getting lazier and worse at honoring agreements.
You should also monitor any changes in his emotional life. It could be that he starts to always be in the same unvarying mood—or conversely, that he starts experiencing dramatic mood swings.
Then of course there’s increased self-centeredness. And finally, another danger signal is alterations in your partner’s sexuality—if he exhibits markedly enhanced or diminished sexual energy, or if his sexual interests change.
Looking back on the last few years with all this knowledge, I can see now that yes, Frederik was starting to make poor decisions more often. But in fact I thought that the change was in me—that I was getting older and smarter and less youthfully uncritical in my adoration of him.
A few times, he also acted impulsively in a way I doubt he would have before—for instance when he bought Niklas’s camera or the Alfa Romeo. Yet it’s hard to say exactly when it wasn’t just a normal development in his old self, but him actually becoming another person.
And compared to the husbands of all my friends, he didn’t grow lazy, though with respect to his own standards he certainly did. In the old days, he shirked his domestic obligations plenty of times; the difference was that when he did so then, it was always because he had more important things to do at school. Now he’d do it sometimes just so he could loaf around at home. And I thought, Finally! We started kicking back together on the weekends in a way that I’d begged for in vain for more than ten years. Never mind that I had to cut the grass after we’d agreed he would. I didn’t care.
Did he start having a harder time controlling his emotions? Yes, he probably did. In the last couple of years before the operation, he occasionally became angry or upset like he never had before. But I found comfort in that too—because it meant we were together. Because I no longer felt he was hiding his feelings from me. At last he was letting me in. And it didn’t seem pathological. None of his changes seemed the least bit pathological.
I’ve read that an increase in the number of arguments is often the warning signal you notice first. That’s because in a family context, where everyone’s evolving and interconnected, it can be hard to single out changes in one person. And Frederik and I did begin to argue, in the car; I’d tell him that he took alarming risks in traffic, and he’d shout back that I’d gotten more chicken since we first met. The truth probably lay somewhere between—or so I thought until recently.
Yet by and large we argued less than before. In the old days we would argue a lot about his absence from our family. And that stopped.
So when did the insidious changes begin—when exactly? Among all the thousands of chaotic little conflicts and oddities that make up everyday life in a family, what’s the first episode, however minor, that I can point to and say Frederik wasn’t himself?
The earliest one I can come up with and date precisely was on our anniversary six years ago. As his gift to me, Frederik bought a cheese. I was furious—especially because I still felt bitter about his affair with the English teacher that I’d uncovered a few years earlier.
“I’m sure you didn’t buy her a cheese!” I yelled.
And he was, yes, perfectly rigid in insisting that it was a fine romantic present. “A delectable cheese!” he said, again and again. “It was expensive! We’d never buy a cheese like this if it weren’t our anniversary. We’ll have a great time eating it and savoring it together.”
And he persuaded me that I was the one being rigid, though of course we didn’t use that word. That I wasn’t being open and modern if I couldn’t see how romantic it would be for us to enjoy ourselves with that cheese and some fine wine.
Now I think differently about every single detail of our eighteen-year marriage … It is a weird gift for an anniversary, isn’t it? A cheese?
Would a perfectly healthy Frederik have come up with that? I’m genuinely convinced that he wouldn’t have. And that was six years ago.
• • •
I’ve lost all sense of dignity and am standing doing stretches up against the wall, to get rid of my leg cramps, when a secretary calls Frederik in.
Herdis Lebech, who will now pass judgment on us, turns out to be a small, smiling woman with an enormous pelvis. She ushers us into an office with overflowing shelves. It could easily belong to an accountant or an insurance agent if it weren’t for the plastic model of a brain that stands on a table right in front of my chair. The brain’s wrinkled surface has been painted neon red and pale blue, so that it resembles the face of a mandrill.
“The Medico-Legal Council has sent me the reports from your earlier examinations. In addition, I have here the scans from before and after your operation,” she says, addressing Frederik. “What I’d like to do first is have the three of us talk together. After that, I’ll ask your wife to leave, so that you can concentrate on some new tests I have for you. And finally, I’d also like to speak alone with your wife, if that’s all right with you.”
Frederik sits calmly in his chair. “That’s quite all right with me. No problem at all.”
“Good. As a starting point, can you tell me how you felt about the other examinations you’ve had?”
Frederik starts talking, and he sounds perfectly healthy! It’s in his tone of voice, his choice of words. It’s that he himself takes the initiative and talks about more than he’s been asked. He’s the old sensible Frederik.
I’m overwhelmed, and after a couple of minutes I can’t sit still any longer, I feel compelled to interrupt him. “Frederik! This is fantastic, really fantastic! I haven’t heard you talk like this in an eternity! You’ve gotten so much better!”
“Yes, I’m getting better all the time. But I was actually about to tell the doctor about this test.”
Frederik goes on talking, until a little later when I feel the need to break in again. “I’m getting a bit worried now that Dr. Lebech will get the wrong impression of how sick you really are.”
He replies with the easy charm he used to be praised for. “Mia, you need to trust the doctor. Dr. Lebech is a neuropsychologist. You should have no trouble assessing my condition, right, Doctor?”
“That’s right.”
I look at Frederik and the doctor in turn. “But perhaps you should also show Dr. Lebech how you usually are—how you’ve been at home with me during the last few months.”
“I’m not going to act like something I’m not! That would be dishonest. And besides, Dr. Lebech is going to report on how sick I was then, not how sick I am now. The postoperative swellings have been exerting a pressure on my brain that is distinct from the pressure exerted by the olfactory meningioma they removed. So my symptoms after the operation should in any case differ from my symptoms before—right, Doctor?”
“Yes, that’s quite correct.”
“Good,” he says. “So if I could just be allowed to continue …”
My friends have told me it can be obnoxious, all the neurological terms I’ve started using in conversations on almost any subject. Frederik has never lain awake at night and read the scientific literature like I have. Nevertheless, he’s apparently picked up some technical expressions even I wouldn’t use.
I make an effort to sit quietly, but a few minutes later I simply have to interrupt again. “Frederik, why are you so well all of a sudden? It’s wonderful, of course—but why just now?”
“No need to exaggerate my illness, Mia! I feel in fact that I’ve been healthier the whole time than you make me out to be.”
“There, now you sound sick again.”
“I had better interpose here,” the doctor says. “It’s completely normal for someone to function better during an examination like this than in everyday life at home. If you’ve been anxious about this exam, the right level of stress in your brain—not too little, not too much—can eliminate your symptoms temporarily.”
She looks at me, and her pale round eyes twinkle in her pale round face. “Mia, of course you wish that Frederik could be like this all the time. But he can’t. It isn’t something he can control. And if he does have some hours when it goes well, then he may also become terribly tired afterward. What you and I find normal is an Olympic performance for him.”
I’m extremely impressed by this moon-woman. I came in here thinking I’d have to argue in some Kafkaesque show trial, yet after just a few minutes she’s displayed more understanding for my situation than my friends. It’s almost like when I talk to Bernard.
“I know,” I say. “And I’ve seen it come and go many times, but I’ve never seen … And I hope you don’t get the wrong impression.”
“You can trust me not to. That’s also what Frederik’s court case is about. A year and a half ago, you were much, much less sick than you are now, Frederik. And you seemed to be healthy nearly the entire time—though perhaps you needed to leave work earlier than you were accustomed to, didn’t you?”
“That’s right, I did.”
“Yes, you needed to relax with something that wasn’t too demanding. Maybe you watched TV, maybe you sat in your yard a bit to unwind?”
“Yes, that’s what I did.”
“Did you have headaches very often when you were relaxing at home?”
“I did.”
“But my male patients don’t ever tell anyone about them—so you probably didn’t either, did you.”
“No.”
“And so if one day you were feeling especially tired, or had a couple glasses of wine, or perhaps had been brooding about something that had worried you all day, then you’d experience the opposite of what you’ve been experiencing today with this exam, right? Your symptoms would manifest themselves. And then you couldn’t be trusted. Or could you, Frederik?”
“No, I couldn’t. I did some terrible things.”
“Yes. With the type of tumor I’ve seen on your scans, you might end up making some mistakes you would otherwise never make. And that would put a serious strain, wouldn’t it, on a marriage—or a work environment. But then of course it’d only be due to the disease.”
I sit up with a start. Her words just seemed to spill from her mouth, but didn’t she say what I’ve dreamt of ever since Frederik was arrested?
I strive to maintain composure. “You say it was due to the disease?”
“That would normally be the case. But now of course I just need to speak more with Frederik.”
She gazes at me with large sparkling eyes. She smiles again, and when she blinks, she does so slowly. As if she wants to tell me something she mustn’t say before she’s conducted the entire formal examination. I get goose bumps and can’t stop staring at her.
“From what I’ve read about Frederik, and the scans …” Her voice sounds just as relaxed as it was a moment ago. And then she repeats what she said, just as quietly. “It would normally be due to the disease. It wouldn’t be something he could help.”
She gives me a box of tissues she has standing behind the plastic brain. While I cry, Frederik doesn’t say anything, he just puts his arms around me and holds me like in the old days.
I don’t know how much time passes before I feel somewhat coherent again. I’m enveloped by Frederik’s body heat and he’s whispering small calming words in my ear, so that I feel his breath against my temple and throat. I look over at the doctor and say, “Thank you.”
I try to explain. “Everything else is so difficult. Just trying to cancel the subscription on Frederik’s phone or getting a plumber to come out. I thought that here I’d also have to argue and complain and … and I planned all kinds of things I was going to tell you about the Iowa Gambling Task.”
“I know that study quite well. Neurophilosophy is my great passion.”
“Neurophilosophy?”
“Yes—applying the methods of neurological research to questions of theoretical philosoph
y. Just as Damasio does with Descartes.”
Then Frederik resumes his account and I try to collect myself, staring into the convoluted folds of the plastic brain before me. Small letters on the region closest to me say INTERPRETATION OF SMELL, while alongside there stretches a belt composed of many small areas: INTERPRETATION OF TASTE, ABDOMEN, THROAT, TONGUE, TEETH.
16
Dr. Lebech’s test of Frederik’s neurological function lasts only ninety minutes, but she’s chosen tasks that challenge him where he’s weakest, and when he emerges from her office, he’s so beat that he can barely walk straight.
Twenty minutes later, after I’ve been in to talk with her too, he’s asleep in the waiting room, half reclining and half sitting across two chairs. I let him sleep, and I walk out to the parking lot to call Niklas.
“The doctor said Dad’s innocent!”
On the phone, it sounds as if Niklas is surrounded by friends speaking in loud voices. Apparently, his meeting of the social committee for the gymnasium isn’t over yet. He speaks in a low voice, his mouth pressed to the receiver. “But wasn’t it going to be in a few weeks that they—”
“Yes, this wasn’t the actual psychiatric report for the court case, but the examination that the Medico-Legal Council will use to make the report. It’s a step on the way—a huge step! And Dad was much more himself today too. I think you should stay home tonight so we can celebrate.”
Silence.
And then his voice, still almost a whisper: “Do I have to?”
“No, you don’t have to, Niklas. But this could be one of the most important days of our lives. Shouldn’t we spend it together?”
“But it’s not today that’s the most important day, is it? You just said that it isn’t until—”